My typical M.O. with this blog, as you may know, is to sing the praises of natural parenting, to cheer- lead those who walk this path, and sometimes, to express a bit of scorn over the parenting status quo. I have preferred not to use the blog as a personal journal because I'm not entirely sure the mundane details of my life are all that riveting.
That said, I am going to veer a bit from that course today. Perhaps you, dear reader, have been where I am on my journey. Perhaps one day in the future you will be where I am. Maybe I can help you, or you can help me.
So - if you haven't read this blog before, here's a quick history. I'm 18 weeks pregnant with my third child. I am a die-hard homebirther. I had my first baby at a birth center (due to the mistaken notion that having a baby in my LA apartment wouldn't be a good idea). My second one was born at home. My plan is, of course, to birth number three at home as well.
Today, I went to a traditional MD because natural remedies haven't worked and I have not been able to take a clear, un-mucousy breath in ten days. The MD gives me a breathing treatment, and being conservative in prescribing medications, wants to discuss with my midwives' back up doctor which prescription would be safest and best. Hours later, she calls me and tells me that the back up doctor was incredibly rude to her, and that he said he only backs up my midwives in birthing emergencies and didn't want to be involved. She recommends I either not homebirth, or at the very least find an OB that she can consult with.
This news about my midwives' backup doctor puts me in tears. I called my dear friend who is an apprentice midwife and cry on her shoulder. After listening to me, she helps me realize why I'm so upset - it's because I don't feel safe with my midwife situation. I didn't realize it until she said it. As of today, I don't feel safe to birth.
From the beginning, I've had consternation about the practice I've chosen. I picked it because the main midwife has decades of experience and has a spiritual practice in line with mine.. she actually helped me through a miscarriage I had a year and a half ago. The thing is, she is now in practice with two other midwives, and they are on a rotating schedule. There is no guarantee that she'll be at my birth.
And with regard to this back up doctor situation.... I have it on good authority that there is only one doctor who backs up any midwife in my area - that that doctor is the aforementioned jerk - and that my midwife is the one he backs up. I have also heard questionable things about his surgical skills... which, were a hospital transfer necessary, would be pretty darned important.
In my thinking today, I mourn the loss of the midwife who delivered my second child. I felt safe, and loved, and perfectly content and at peace to birth in her hands. Unfortunately, I no longer live in LA, so I cannot birth with her again. I realized, after thinking about her versus my current situation, that there are three things that, in my mind, make me feel safe to homebirth:
1. the midwife is very experienced and particularly experienced with post partum hemorrhage
2. the midwife has a good relationship with a back up doctor and a back up hospital (I learned this the hard way after a horrendous experience with midwife #1 versus the local hospital and my transfer for post partum hemorrhage)
3. I have a one-on-one bond between a midwife and myself.
These factors don't seem to be present in my current situation. Also, and this is a little niggling thing, my midwife team isn't that great at promptly returning calls and paperwork follow through.
So what to do? Should I give it more time with my current team? They are lovely, and gifted midwives from all accounts. And - I've only had two visits with them thus far so perhaps my outlook will change. Or should I look around and see if there's a better fit? Frankly, I'm not entirely sure I can achieve my 3 safety goals with anyone given the reported lack of back up doctors in the area, and area midwives' reported reticence to stray too far from the city in which they practice. That fact alone is particularly scary to me.
I will, of course, turn within and meditate and pray on this. But if you have any input, I would greatly appreciate it.
Warmly,
Katherine
Oh Katherine - I'm so sorry you are going through this. I know how you feel (remember when I layed out my birth story for you as a comment in one of your posts?) Having to be transfered from my midwife to an OB; from the idea of a home birth to an actual hospital birth - if was awful and scary. And like you I didn't feel safe with that option. But - it was out of my hands. I had a rare condition and my midwife could not help me (withoug losing her license.) If I were you I would be looking for someone else. I know that all three of your safety goals may not be met by one midwife but, you have to at least feel SAFE with her and if you can find that comfort perhaps that will alleviate the other fears. A better fit sooner than later is optimal - especially knowing how you feel about anxiety affecting the fetus. I would be happy to do some journey (shamanic) work for you...if you like. Sending lots of love. -Debbie <3
ReplyDeleteThe first thought that comes to mind is that doubt means no. What is the harm in spending time with other midwives in the area (is there more than 1 other?) to get a feel? You are an intuitive person and you are early enough in your pregnancy to make an informed decision. I can't offer advice on the backup Dr. situation-- as I also haven't heard the best about him, especially his surgical skills. And another thought -- what about exploring a little further east? Is there a midwife with a backup in Stockton? Maybe an OB who's willing to work with you personally as a backup? I think you already know your answer though, and just need to sit with it before acting on it. Wishing you peace of mind.
ReplyDeleteComing from another jurisdiction, I have to say I don't understand this notion of "back-up doctor". I guess midwives are fully integrated into the system in British Columbia that traditional doctors/hospital will only take over where necessary. The midwife is considered competent to deal with normal healthy births and no consultation is needed. So I can't say that I would be concerned about having the doctor only there for emergencies, I see that as how it should be. But it does sound like you aren't feeling as fully supported as you would like with your team. Perhaps you can quietly look around and see if there is anyone out there you would trust?
ReplyDeleteMy birth got supremely effed up because of the *political* situation surrounding my pregnancy rather than any *medical* condition involved with it. I was having twins and wanted to be able to choose a non-hospital birth (we also chose a birth center, gets me wondering which one you birthed at? Not very many here in the LA area...) If I had it to do over again, I would have found a midwife who would have openly worked with me and her backup OB on our birth plan, instead of all the sneaking around behind the back that we did. Or I would have found an OB who supported my desire to have an unmedicated, non-interventionist birth in a regular birthing room (not the OR, where I did eventually deliver).
ReplyDeleteThe lesson I took away from my birth is that the whole team really should be solid. Of course, sometimes you have to create your best situation out of what is available to you, but if I were in your shoes I would at least be exploring my other options.
Also, have you personally called or visited this OB in person? Maybe they just have really crappy phone skills?
Dear Katherine, I am sorry you are in this predicament. AND we know it is all happening for a reason. I know of your strong desire to homebirth, and I am also hearing signs that perhaps the Universe is directing you in a different way. I have tried to still my thoughts and listen for you and what I seem to be getting is she needs to find an OB she can trust and go from there. Take it for what it's worth. I just keep getting the image of square peg round hole, perhaps there is something different about this pregnancy none of us can see right now AND I affirm you and your Guidance and your ABSOLUTE health and wellbeing for you and your child. As far as the doc with the questionable surgical skills yikes. There must be a female OB out there somewhere who can support your values and intentions.
ReplyDeleteMy personal experience is that of hospital birth, and that was always my Guidance.That being said, I did all my laboring at home arrived at the hospital 9 1/2 cm. dialated. June was born within an hour and a half of arriving there!!! Homebirth would have been a total disaster for me. To be clear I am not advocating hospital birth, that is just where I needed to be. I know from your previous experience your body is much better equipped for childbirth than mine, you are very fortunate in that respect. I totally support the path to which you are dedicated. And I support your listening to what the deeper message is.
You are so fortunate as well to be in CA. Here in NC it is illegal for midwives to assist in the home, you have to be in a birthing center. Crazy. Especially since a family friend of ours birthed all 6 of her children at home, just her and her husband. Now she is amazing! You will know what is right, it's the letting go that is the challenge. Much Love, Nelle
Debbie, you are so very kind...I do think my guidance is to find a new midwife - although I do really like those I have now personally. It doesn't make too much intellectual sense at this point but I just can't get to feeling okay with the way it is.. and I do have to listen to that. My husband called our LA midwife last night... it would bring me great joy if she would agree to care for me and baby - and if we can work out the crazy logistics of it all! I would love some journey work.. tell me more (kchavener@att.net).
ReplyDeleteKat, I think you've hit the nail on the head about my guidance on this matter. Reese called our LA midwife.. not sure if that will work out or not. Otherwise, I am going to look and see if I can find a situation that feels right to me intuitively.
ReplyDeleteAh Maria, the political situation with midwives is really crazy here. Docs liability insurance prevents them from backing up midwives, yet the law requires midwives to be "backed up." So basically there's a wink and a nod that the law is going to be disregarded. It's insane. Adding to the problems, most hospitals take a very unkind eye to women that birth at home - including the hospitals that are closest to me. The treatment I received after having to transfer to the hospital after my first baby (for PPH) was horrendous. I will blog about it soon. So it makes me very wary - and very clear that I need to have that there to feel safe to birth. Thanks so much for your input!
ReplyDeleteLindsey - that is EXACTLY how I feel. I birthed in Simi Valley actually at Rasmia Tebo's birth center. (it's since closed). We lived in Toluca Lake at the time so it was quite a drive! When I had to be transferred after Brianna's birth, the local hospital (Los Robles in Thousand Oaks) were horrendous to me. Failed to treat me for 6 hours, telling me the whole time that no one wanted to treat me because of liability issues with homebirthers. AS with you, the lesson I learned is get a solid back up situation in place. Davi Khalsa, my second midwife Elea, had this in place with Dr. Crane at Cedars. I cannot imagine getting embroiled in the whole political situation with delivering twins.. it's so insane that twins = c/s. I'm so sorry that you had to go through that.
ReplyDeleteNelle - thank you so much for your love and prayers. You are right about the square peg/round hole. Something is just off, as much as it doesn't make sense to me right now.. I mean these ladies (midwives) are lovely! My guidance last night was that I am not going to even need a back up situation - that this baby will be delivered easily and peacefully at home. However - I still can't ignore the guidance that seems to be coming that the current situation isn't right. I truly would never - without real medical reason - deliver at a hospital. There's just too much there out of your control... too much pressure, politics, just yuck. But I know intuitively that I need there to be a positive hospital back up plan in place such that I can feel comfortable to sink in and enjoy this pregnancy and the birth.
ReplyDeleteYou've got me curious now why you think it would be a disaster if you homebirthed? Sounds to me that you'd be a perfect candidate since you labored at home all that time, and Angelina came out quickly once you got there. Were there complications?
I've changed care providers midway through both of my pregnancies - the first time from OB to midwifery care and the second from a midwife clinic I didn't feel absolutely comfortable with to one that I absolutely loved (and felt loved by). When it comes to birth feeling safe is enormously important and little niggling doubts can have a big impact. I'm glad to hear your husband got in contact with your LA midwife. :)
ReplyDeleteDuring my pregnancy with #2, I needed to be on progesterone. After getting pregnant I made my appointment with the ob to refill my prescription and let her know I was officially pregnant. When chatting with the nurse, i mentioned I was thinking of having this baby at home. Minutes later we were being physically removed from the building. Two nurses stood in the hallway blocking us from walking back in towards the doctor. Crying and humiliated, I asked to be seen by the doctor for a refill of the drug that should I suddenly stop, I would miscarry. The doctor agreed to see me for a short time solely to write me a prescription. Weeks later I found a new doctor and just never told him my plans. I finally stopped seeing him for every appointment at about 20 something weeks and just crossed my fingers that he'd take me as a patient months later if I needed him. For #3 I did the same thing. Lying to my doctor for only three months this time until just believing my gut instinct that everything would be just fine. I would get help if I needed it by someone that would be on call at the hospital. I wasn't about to tell the truth to any doctor and get physically removed again. I actually received a letter during that second pregnancy that said legally I was not every allowed in their building. This all sounds as if I was being crude or unruly, and the truth is that I was only sobbing quietly into my husbands arms in their hallway as they stood next to each other ready to take me down. Needless to say my opinion of doctors isn't very high.
ReplyDeleteHI Katherine! I know this is an older post, but I have just been introduced to you by a friend who found your Nursies book. I have a 2.5 year old boy who is still nightnursing and we are trying to figure out how to nightwean gently, so thanks for that...
ReplyDeleteI am glad that to have found your blog. I do AP in a small town where we seem few and far between. It is nice to know there are other's out there who don't think I am totally insane. Anyway- I appreciate this post because I went from homebirth to c-section for no real medical reason except for a crappy midwife and a doc who wanted to get back to bed.
I knew it from the moment I met her that we weren't a good fit - but she was my ONLY option if I wanted to homebirth. I thought I could make it ok. But I was so wrong. She was rude to me during the labor and even then I didn't have her leave and make different choices... So strange to be so sad about how the situation turned out but to have felt so powerless in the moment. Even when we got to the hosp - after 3 days of labor at home, I was pooped. No one advocated that all I needed was to sleep and then I could have delivered vaginally. That is all I needed. How did I end up with a "horror story" (Ok I know there are much worse...really I do) birth. I just never thought I would be one of those births... Anyway I appreciate this blog for that reason - it helps me validate what I know to be true, I shuda dumped her... She was in my way of a successful birth.
We are starting to talk about baby number two and looking into our options for birth... I want a homebirth but I know better than to settle for someone like her again.
Thanks!!!
Hi Erin,
ReplyDeleteThanks so much for your comment! I am very sorry that you had this experience - I am sure it was so disheartening. I wish there were more choices for you there where you live! I will hope and pray that you will be able to find a solution this next time around so that you can have the homebirth (HBAC!!) you deserve. Also glad to hear that you found my book. I hope it helps you get some sleep!!
Best regards - Katherine